Recently, I came across an article in our local newspaper about a training program at one of Vermont’s hospitals for certification in “dry needling.” I asked friends if anyone had used this technique and it turns out three people had with good results. Two were for shoulder pain.
WHAT IS DRY NEEDLING: Dry needling dates back to the 1940s. Designed to ease muscular pain, a practitioner, usually a physical therapist, inserts several filiform needles into your skin. These are fine, short, stainless steel needles, similar to an acupuncturist needle. The needles are placed in trigger points (knotted or hard muscle tissue). The goal is to release the knot and relive muscle pain or spasms. Needles remain in your skin for a short period of time.
Dry needling appears to be safe, minimally discomforting and often an effective technique for patients with certain musculoskeletal presentations. Not the same as acupuncture, dry needling uses similar tools, and is performed by different practitioners with different training. Acupuncture is based on Eastern medicine, while dry needling is rooted in Western medicine and evaluation of pain patterns, posture, movement impairments, function and orthopedic tests.
Rarely a standalone procedure, it is often part of a broader physical therapy approach incorporating other traditional physical therapy interventions into treatment.
WHAT THE RESEARCH INDICATES:
A recently published study, using randomized double blind clinical trial of patients with chronic neck pain, concluded, Deep dry needling of the trapezius muscle, regardless of whether it is on a trigger point, latent or non-trigger point area, produces the same positive effects in improving pain intensity, discomfort and local mechanical hyperalgesia.
Using a meta analysis, a November 2021 study concluded that Treatment with invasive physiotherapy, combined with conventional physiotherapy, seems to have positive effects in reducing spasticity, although more studies are needed to improve the heterogeneity of the interventions and to assess their long-term effectiveness.
Hip Pain and Dry Needling: Evidence indicates that greater trochanteric pain syndrome, chronic pain and tenderness on the outside of the hip can be treated effectively with physical therapy and specifically with dry needling to this area. Dry needline is as effective as cortison injection in reducing pain and improving movement. Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial” (J Orthop Sports Phys Ther 2017;47(4):232-239. doi: 10.2519/jospt.2017.6994).
WHERE IT’S BEING USED: The American Physical Therapy Association states that Dry Needling is within the scope of practice for a Physical Therapist. Hospital for Special Surgery in NYC, which focuses on a number of specialties including orthopedics, rheumatology and sports medicine, uses it as part of their physical therapy program. The Mayo Clinic is using it as well. Check with your provider to see if it's available in your area.
Note that it’s not always covered by insurance, but generally will be covered if it’s part of a physical therapist’s treatment. The following states- Washington, Oregon, California, New York and New Jersey-prohibit its use.
WHEN NOT TO USE IT
• If you have an infection
• Are pregnant
• Are needle phobic
If you have any of the following: bleeding disorder; compromised immune system; diabetes; epilepsy; lymphedema or vascular disease, be sure to let the therapist know.
POSSIBLE SIDE EFFECTS: Soreness during or after the procedure. Bleeding where needles were inserted. One friend said that while it had worked for her, she had nausea with it.
SHOULD I TRY IT ? If you have chronic pain, talk to your medical provider about whether this could be of help to you. Be sure to use a well-trained therapist.
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